Journal of Rehabilitation Medicine 51-4inkOmslag | Page 33

Impact of PiD on outcome after TBI and aSAH
Table II. Relations between hormone function during the first year
after traumatic brain injury (TBI) and aneurysmal subarachnoid
haemorrhage (aSAH), and Barrow Neurological Institute Screen for
Higher Cerebral Functions (BNIS) results at 12 months post-event
BNIS
Hormonal axis
Thyroid n  = 74
Low levels n  = 20
Normal levels n  = 37
High levels n  = 17
Adrenal n  = 60
Low levels n  = 8
Normal levels n  = 21
High levels n  = 31
Somatotrophic n  = 78
Low levels n  = 9
Normal levels n  = 56
High levels n  = 13
Gonadal n  = 76
Low levels n  = 29
Normal levels n  = 47
Prolactin n  = 77
Low levels n  = 3
Normal levels n  = 66
High levels n  = 8
Mean (SD) Median Range
LL vs NL HL vs NL
p-value p-value
26.1 (25.5) 22
36.5 (22.7) 43
20.2 (21.7) 16 0–63
0–64
0–58 p  = 0.179 p  = 0.018*
21.1 (24.8) 8.5
34.8 (23.9) 43
29.4 (24.2) 35 0–58
0–63
0–63 p  = 0.218 p  = 0.500
28.8 (28.1) 13
32.2 (23.2) 38
17.1 (21.5) 0.9 0–63
0–64
0–53 p  = 0.894 p  = 0.012*
24.1 (23.2) 24
32.2 (23.8) 39 0–63
0–64 0.6 (0.5)
0.9
31.7 (22.6) 38
15.9 (27.6) 0.5 0–0.9
0–64
0–63
p  = 0.142
p  = 0.027* p  = 0.079
***p  < 0.001, ** p  < 0.01, *p  < 0.05.
SD: standard deviation; LL: low levels; NL: normal levels; HL: high levels.
Thyroid axis
BNIS T-scores were significantly lower (p = 0.018) in
the subgroup with high thyroid levels in comparison
with those with normal thyroid levels. Patients with
high thyroid levels were significantly (p = 0.016)
older (mean 60.4 years (SD 9.5) than patients with
normal thyroid levels (mean 50.6 years (SD 14.9).
Comparisons of the other baseline variables showed
no significant differences in any subgroup.
Multiple linear regression analysis demonstrated
significant associations between BNIS T-score at 12
months after the event and age (b = –0.44, p = 0.027,
CI: –0.83 ––0.05), GCS (b = 1.48, p = 0.036, CI:
0.10–2.87), but not with sex (b = 7.42, p = 0.170), or
with high T4 (b = –12.46, p = 0.063), or with low T4
(b = –10.08, p = 0.095). Thyroid level, age, GCS and sex
explained 20.4% of the variance in the BNIS T-scores
(adjusted R 2  = 0.204).
Somatotrophic axis
BNIS T-scores were significantly lower (p = 0.012) in
the subgroup with high IGF-I levels in comparison
with those with normal IGF-I levels. Patients with
high IGF-I levels were significantly (p = 0.021) older
(mean 60.8 years (SD 9.8) than patients with normal
IGF-I levels (mean 50.6 years (SD 14.8)). Comparisons
of the other baseline variables showed no significant
differences in any subgroup.
Multiple linear regression analysis demonstrated
significant relationships between BNIS T-score at 12
months after the event with age (b = –0.49, p   = 0.011,
267
CI: –0.88––0.12), and GCS (b = 1.42, p = 0.042, CI:
0.05–2.79), but not with sex (b = 5.39, p = 0.311), or
with high IGF-I (b = –10.33, p = 0.142), or with low
IGF-I (b = –0.91, p = 0.907). IGF-I level, age, GCS
and sex explained 17.1% of the variance in the BNIS
T-scores (adjusted R 2  = 0.171).
Prolactin
BNIS T-scores were significantly lower (p = 0.027) in
the subgroup with low prolactin levels in comparison
with those with normal prolactin levels. Comparisons
of the other baseline variables showed no significant
differences in any subgroup.
Multiple linear regression analysis demonstrated
significant relationships between BNIS T-score at 12
months after the event with age (b = –0.513, p = 0.005,
CI: –0.87––0.16), GCS (b = 1.35, p = 0.043, CI:
0.05–2.65) and low prolactin (b = –31.02, p = 0.016, CI:
–56.15––5.89), but not with sex (b = 5.81, p = 0.274)
or with high prolactin (b = –13.83, p = 0.083). Prolac-
tin level, age, GCS and sex explained 23.6% of the
variance in the BNIS T-scores (adjusted R 2  = 0.236).
Adrenal axis and gonadal axis
BNIS T-scores did not differ between subgroups with
different cortisol levels (p = 0.468) and gonadotrophin
levels (p = 0.267).
Multiple axes
Multiple linear regression analysis demonstrated no
significant relationship between BNIS T-score at 12
months after the event and low (b = –3.00, p = 0.572)
or high hormones levels (b = 3.53, p = 0.492).
RLAS-R and pituitary dysfunction
Data are displayed in Table III.
At 12 months, 51% (46/91) patients had ”inferior
cognitive functioning” and 49% (45/91) had ”superior
cognitive functioning”.
Thyroid axis
RLAS-R scores were significantly lower (p = 0.026)
in the subgroup with high thyroid levels in compa-
rison with those with normal thyroid levels. Patients
with high thyroid levels were significantly (p = 0.011)
older (mean 59.9 years (SD 9.3) than patients with
normal thyroid levels (mean 50.0 years (SD 14.7).
Comparisons of the other baseline variables showed
no significant differences in any subgroup.
Multiple linear regression analysis demonstrated
significant relationship between RLAS-R score at 12
J Rehabil Med 51, 2019